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Individual

TEMALESI CAGINIVALU DAVETA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
933 EDWARDS AVE APT 2, SANTA ROSA, CA 95401-4239
(707) 239-2400
Mailing address
933 EDWARDS AVE APT 2, SANTA ROSA, CA 95401-4239
(707) 239-2400

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
7511054388
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D1727157
DRIVERS LICENCE
CA
Enumeration date
01/09/2025
Last updated
01/09/2025
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